D53.9 vs D64.9
D53.9 and D64.9 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on D53.9
anemia NOS (D64.9)
D53.9
Nutritional anemia, unspecified
BillableUnspecified
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D50-D53
Use when the record says
- Simple chronic anemia
Indexed under
- Anemia › deficiency (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Anemia › macrocytic (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Anemia › malnutrition (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Anemia › nutritional (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Anemia › simple chronic (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
D64.9
Anemia, unspecified
BillableUnspecified
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D60-D64
Indexed under
- Anemia (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Oligocythemia
- Anemia › atypical (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Anemia › idiopathic (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Anemia › normocytic (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027